全身转移性黑素瘤1例.pdfVIP

I02BI~~~始脱品在|在iiIjt126 阳1.11 全身转移性黑素瘤 1 例 朱文静，李雪，金仙花，于凯，牟娇，夏建新 [摘 要] 患者女，60 岁。头面、躯干、四月支大小不等黑红色结节，无痛痒 3 年，半年内泛发全身。皮肤科情况:头 面、躯干、四月支见大小不等高粱粒至黄豆大小结节，呈皮色、暗红色及黑色。左膝关节上方见一直径约 2cm x2cm 大小肿块，其上见4 -5 个大小不等皮色至黑色结节，部分结节表面结痴。皮损组织病理示: 真皮内弥浸性肿瘤样细胞浸润，此肿瘤样细胞核大、核仁明显，部分肿瘤样细胞呈巢状排列，肿瘤组织 内见坏死。免疫组织化学染色显示肿瘤细胞 LCA( - ) , CK20( -) ， Sl∞蛋白及HM1M5 弥漫强阳性， Vimentin 弥漫阳性。诊断:黑素瘤。 [关键词] 黑素瘤;转移;病理;免疫纽化 [中图分类号] R 739. 5 [文献标识码] B [文章编号] 1001 -7089( 2012) 11 - 1028 - 02 A Case of Cutaneous Malignant Melanoma Metastatic to Whole Body ZHU Wen-ji吨， LIX肘， JIN Xian-hua , YU Kai , MU Yan , XIA Jian叹m (Department of Dermatology , the Second Hospital of Jilin University , Changchun 130041 , China) [Corresponding authorJ XIA Jian-xin.E-mail:jianxinxia2003@ [AbstractJ A 60-year old female presented with a 3-year history of black or red rashes of varying sizes on her head , face , trunk , upper and lower limbs. The number of rashes was increasing during last 6 months. Physical ex- aminations showed skin-color , dark red and black nodules on her head , face , trunk , upper limbs and lower limbs in size of sorghum grain to bean. A mass on her left knee in size of 2cm x 2cm with 4 - 5 skin-color or black nodules of varying size on it , some of the nodules covered with scabs. Histopathological examination showed infi1tration of crowded tumor-like cells in the dermis. The tumor-like cells had large nuc1ei and prom- inent nuc1eoli. And the aπangement of these cells was nest-shape with necrosis within the tllmor tissue. Im- munohistochemical stain showed tumor cells were LCA and CK20 negative , S100 and HM B45 diffusely strong positive , vimentin diffuse posi